I must confess that I am one of those people who love the feel and smell of books, magazines, and, yes, journals. I appreciate being able to point, click, and read on release a latest issue on the Web wherever I am, but where at any given moment an electronic journal actually is remains a slightly disconcerting mystery to me. The print version of Annals, however, is something I can hold and pretend to possess, readily identifiable and distinguished by the gentle green cover with the leaf. In hard copy, it can even be measured using old-fashioned tools, like a ruler. Indeed, if you stack and firmly press together printed copies of all 6 issues of Annals during its first year of publication and add the first supplemental issue, Annals of Family Medicine measures at 1 year of age approximately 26.6 cm × 19.8 cm × 1.4 cm and thus occupies about 737.4 cc of space—slightly more space than a couple of cans of soda pop. Together, the first year’s issues include 480 pages, 283.5 (59.1%) of them filled with original research, yielding an attainable if silly metric of 1 original research manuscript occupying on average 10.4 cc of space—an astonishingly small amount of space for all the work that goes into them. To my knowledge, there is no standardized growth curve for a journal, but unencumbered by my ignorance, I choose to conclude that this is consistent with normal growth and development.

If decades of relentless commitment to the development and financing of fragmented, subspecialized medicine could solve the health problems that beset our people and the health care problems that flourish in our nation, one would expect the United States to revel now in both splendid health and fabulous health care. To the contrary, it is almost certain that never before has a nation spent so much to accomplish so little for so few. If systems are perfectly designed to get the results they produce, we can deduce that the US system of care is designed to discover biological mechanisms and provide a powerhouse economic engine for the economy. If, however, the purpose of US health care were revised to be the relief of suffering and the production of health, a prudent person would conclude that something needs to change to achieve it. Many, maybe even most people who think about health and health care, are convinced that the road to a high-octane, high-performance US health care system must be laid on a foundation of high-performance primary care.¹ This is where Annals of Family Medicine fits in and why it is probably not just another interloper into the world of medical publishing.

Who should care about another medical journal, especially one focused on family medicine and primary care? Just about everyone who has had enough of the disgrace that passes for a health care system in the United States. Just about everyone who has been a patient or witnessed the care of a friend or family member lately. Why? Because alternative ideas not always welcomed in other important journals have been welcomed at Annals of Family Medicine, rigorously reviewed and revised, and provided with a forum for active discussion and further development. Some of these ideas already stand on substantial evidence, some are ripe for fuller exploration, and some are plausibly part of the solutions to our country’s intractable health and health care problems.